Interaction between Menstrual Cyclicity and Gonadotropin Pulsatility

Filicori, Marco; Tabarelli, C.; Casadio, Paolo; Ferlini, Federica; Gessa, Gian Luigi; Pocognoli, Patrizia; Cognigni, Graçiela Estela; Pecorari, R.

doi:10.1159/000023166

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…LH plays an important role in gonadal function. Derangements of pulsatile LH secretion are found in virtually every menstrual disorder (Filicori et al ., 1998). Oocyte maturation, follicle luteinization and ovulation are LH surge‐dependent processes.…”

Section: Discussionmentioning

confidence: 99%

Association of molecular variants of luteinizing hormone with menstrual disorders

Ramanujam

Liao

Roy

et al. 1999

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 99%

Association of molecular variants of luteinizing hormone with menstrual disorders

Ramanujam

Liao

Roy

et al. 1999

Clinical Endocrinology

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“…LH pulsatility reflects the pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus (56). Neural pathways have been traced from receptors in the brain for several metabolic hormones and substrates to the GnRH pulse generator (199).…”

Section: Menstrual Disordersmentioning

confidence: 99%

The Female Athlete Triad

2007

Medicine &Amp; Science in Sports &Amp; Exercise

980

388

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The female athlete triad (Triad) refers to the interrelationships among energy availability, menstrual function, and bone mineral density, which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. With proper nutrition, these same relationships promote robust health. Athletes are distributed along a spectrum between health and disease, and those at the pathological end may not exhibit all these clinical conditions simultaneously. Energy availability is defined as dietary energy intake minus exercise energy expenditure. Low energy availability appears to be the factor that impairs reproductive and skeletal health in the Triad, and it may be inadvertent, intentional, or psychopathological. Most effects appear to occur below an energy availability of 30 kcal.kg(-1) of fat-free mass per day. Restrictive eating behaviors practiced by girls and women in sports or physical activities that emphasize leanness are of special concern. For prevention and early intervention, education of athletes, parents, coaches, trainers, judges, and administrators is a priority. Athletes should be assessed for the Triad at the preparticipation physical and/or annual health screening exam, and whenever an athlete presents with any of the Triad's clinical conditions. Sport administrators should also consider rule changes to discourage unhealthy weight loss practices. A multidisciplinary treatment team should include a physician or other health-care professional, a registered dietitian, and, for athletes with eating disorders, a mental health practitioner. Additional valuable team members may include a certified athletic trainer, an exercise physiologist, and the athlete's coach, parents and other family members. The first aim of treatment for any Triad component is to increase energy availability by increasing energy intake and/or reducing exercise energy expenditure. Nutrition counseling and monitoring are sufficient interventions for many athletes, but eating disorders warrant psychotherapy. Athletes with eating disorders should be required to meet established criteria to continue exercising, and their training and competition may need to be modified. No pharmacological agent adequately restores bone loss or corrects metabolic abnormalities that impair health and performance in athletes with functional hypothalamic amenorrhea.

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“…Females undergo a complex series of neuroendocrine changes throughout the menstrual cycle as outlined by Filicori et al [18] in the present issue. Briefly, the GnRH pulse frequency commences at approximately 90 min in the early follicular phase, due in large part to striking sleep-induced slowing of the GnRH pulse generator at this one specific stage of the cycle.…”

Section: Sexual Maturationmentioning

confidence: 92%

Gonadotropin Pulsations across Development

Hayes

Crowley²

1998

Horm Res Paediatr

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Initiation and maintenance of the reproductive axis in the human is contingent upon the pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. In man, tracking endogenous GnRH secretion relies on frequent peripheral sampling of three glycoprotein products of the gonadotrope, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and free α-subunit (FAS). FAS is superior to LH as a surrogate marker of GnRH secretory dynamics in those circumstances where GnRH secretion is rapid or where the pituitary LH response is low. The pattern of GnRH secretion is constantly changing across development; from high levels during the neonatal period, through a period of quiescence in mid-childhood, followed by sleep-entrained reactivation of the reproductive axis at the onset of puberty, ultimately culminating in the adult pattern of pulsatile secretion which in the male is approximately every 2 h and in the female varies with the stage of the menstrual cycle. This episodic mode of secretion allows differential impact of feedback mechanisms on the GnRH neurons and facilitates the maintenance of the reproductive axis during periods of stress by allowing frequency and amplitude modulations.

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Interaction between Menstrual Cyclicity and Gonadotropin Pulsatility

Cited by 9 publications

References 28 publications

Association of molecular variants of luteinizing hormone with menstrual disorders

Association of molecular variants of luteinizing hormone with menstrual disorders

The Female Athlete Triad

Gonadotropin Pulsations across Development

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